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December 11, 2006

Katrina Begets a Baby Boom by Immigrants
By EDUARDO PORTER
NEW ORLEANS First came the storm. Then came the workers. Now comes the
baby boom.
In the latest twist to the demographic transformation of New Orleans
since it was swamped by Hurricane Katrina last year, hundreds of
babies are being born to Latino immigrant workers, both legal and
illegal, who flocked to the city to toil on its reconstruction.
The throng of babies gurgling in the handful of operational maternity
wards here has come as a big surprise and a financial strain to this
historically black and white city, which before the hurricane had only
a small Latino community and virtually no experience of illegal
immigration.
Of all the myriad things that have changed after Katrina, this wasnt
high on anybodys priority list, said Dr. Mark Peters, chief executive
of East Jefferson General Hospital in Metairie.
Because many immigrant mothers cannot afford to pay for prenatal care
or delivery services, New Orleanss newest citizens are adding an
unexpected load to the decimated health infrastructure in a city
abandoned by many of its doctors. Much of the state-financed Charity
Hospital system, which before Hurricane Katrina provided the bulk of
care to New Orleanss uninsured and indigent population, remains
closed.
Lacking health insurance and barred from most government assistance,
expectant immigrant mothers can go to only the handful of charitable
clinics that are still operating and that do not question a womans
immigration status when offering low-cost prenatal care.
Prenatal care is our daily nightmare, said Shaula Lovera, the program
coordinator for the Latino Health Access Network, an outreach service
operated by Catholic Charities.
The two health units providing prenatal care run by the Louisiana
Department of Health and Hospitals saw more than 1,200 pregnant women
from January to mid-November. Virtually all were Latino immigrants.
Before the storm, only 2 percent were Hispanic; now about 96 percent
are Hispanic, said Beth Perriloux, the head nurse in the departments
health unit in Metairie.
There are so many pregnant women that the clinics have reached
capacity. Dr. Erin Brewer, the departments medical director, said,
Weve gone from having a maternity clinic two to three days a week to
five days a week.
Many immigrant women are forgoing prenatal care and showing up, ready
to deliver, in hospital emergency rooms, where they are required to be
seen even if they are in the country illegally.
When I felt the pains I just went to the womens and childrens
hospital, said Noemi, an illegal immigrant from Oaxaca, Mexico, who
arrived in New Orleans right after the storm as part of a cleaning
crew from North Carolina. She left the city but then returned in
October, a month after giving birth to her daughter Alejandra in Lake
Charles, 200 miles west.
If they hadnt received me, my girl would have been born in the hall,
Noemi said. (She asked that her last name be withheld to protect her
identity.)
There has been a small Latino population in New Orleans for several
decades, mostly Hondurans who came after Hurricane Mitch battered
Central America in 1998. But that population has started to grow.
According to the Louisiana Health and Population Survey, released in
November, the number of Latinos living in households in Orleans and
Jefferson Parishes has increased by about 10,000 since 2004, to
60,000, even as the total population has fallen by about a quarter, to
roughly 625,000.
Last summer, researchers at Tulane University estimated that there
were 5,000 to 7,000 illegal Latino workers in Orleans Parish alone,
excluding nonworking relatives. But some community workers estimate
that tens of thousands have arrived since the storm.
Immigrants can be seen working on roofs, installing Sheetrock and
laying tile all over town, from the up-market Lakeview neighborhood in
the west to East New Orleans. At the Lowes home improvement store in
the citys Bywater neighborhood, clusters of day laborers mill about in
the parking lot every morning, waiting for jobs.
Most are not new to the United States. They come from Texas, Florida
or California, seeking construction work that can pay $150 a day. But
there are some newcomers, including Sara Alvarado, a 26-year-old
Honduran, who arrived in the United States in August after a monthlong
odyssey through Mexico with her partner, Tony, 32.
When Ms. Alvarado finally got to New Orleans, brought into the country
by coyotes, or smugglers, who charged $6,000, she was more than six
months pregnant. The last time she had seen a doctor was four months
before.
The coyotes wanted to charge me more and bring me across in a car, Ms.
Alvarado said, sitting in her cramped room in a shotgun shack in the
Upper Ninth Ward that she and Tony share with four other people. But I
didnt take a single vitamin, and I came across that desert jumping
fences and all that, and look, here is this boy.
She cradled a plump bundle: Jackson Antonio, an American citizen who
came into the world at Tulane-Lakeside Hospital 12 days early on Oct.
17, the day the 300 millionth American was born.
At Tulane-Lakeside, doctors are delivering 215 to 240 babies a month,
which is 60 percent to 70 percent more than before Hurricane Katrina,
said Andr du Plessis, the hospitals chief operating officer.
Some of that increase is because of the lack of hospitals. But the
numbers also reflect the new population. Approximately 20 to 25
percent of the babies are Hispanic, Mr. du Plessis said. Pre-Katrina,
we largely didnt have a Hispanic population.
Dr. Kevin Work, an obstetrician who started a private practice a year
before the hurricane, decided to focus almost exclusively on the
Latino population when he saw the abundance of immigrant women at the
maternity clinics run by the Department of Health and Hospitals, where
he works two and a half days a week.
The demographics of the health units used to be 85 percent
African-American, who had Medicaid, and 15 percent other, Dr. Work
said. When the clinics reopened, I started seeing the faces changing.
Now 85 to 90 percent are Hispanic undocumented, and only 10 to 15
percent have Medicaid.
Dr. Work has been offering a low-cost prenatal care package, charging
about $800 for the full term of a pregnancy, a small fraction of the
typical bill. He also runs advertisements on the two local
Spanish-language radio stations.
The boomlet of Latino babies in New Orleans poses particular
challenges. Nonemergency Medicaid is not available to illegal
immigrants or even to legal immigrants who have been in the country
less than five years. Virtually none of the immigrant mothers-to-be
have private insurance. They are mostly poor. Many fear being
deported.
Hospitals will deliver these womens babies only if they arrive in
labor through the emergency room. There, emergency Medicaid pays for
up to a 24-hour hospital stay for a vaginal delivery and a 48-hour
stay for a Caesarean section, Dr. Work said.
Most of Dr. Works patients do not speak English. At the Department of
Health and Hospitals unit in Metairie, where he sees patients Tuesday
mornings, he relies on the language line, a phone-based translation
service. Sometimes women arrive with one of the Latina translators who
prowl the clinics and charge the patients $60 per session.
Dr. Work said he delivered 50 to 70 babies a month, most born to
Latino immigrants. He even delivered Jackson Antonio, though he could
not remember doing so, the memory lost in a blur of births.
The new population is having a tough time in New Orleans. Jackson
Antonio was required to stay 48 hours in the hospital. But Ms.
Alvarado had to leave after 24. If I stayed longer they would charge
me, she said. She spent the next day looking for a car safety seat,
which hospitals require to discharge new babies.
Health workers at Catholic Charities eventually found a car seat. They
also gave her a crib, so her baby would not have to sleep on a
mattress on the floor. Volunteers at Common Ground, a nonprofit
assistance organization that opened a health clinic after the storm,
have been trying to help Ms. Alvarado apply for assistance for her
child.
Still, Ms. Alvarados life is mostly an endless hustle at the limit of
subsistence. She started Jackson Antonio straight off on baby formula
because she expected to go to work as soon as she recovered from the
delivery. But she cannot leave home, because there is nobody to care
for the baby.
Her partner, Tony, who declined to provide his last name, spends most
days waiting with the day laborers at a Shell gas station near their
home. But with demand for workers slackening, he is having a hard time
finding a job. Just before Thanksgiving he worked 10 hours on an
apartment building, but the woman who hired him disappeared before
paying him his promised $120.
Meanwhile, bills are piling up, starting with repayment of the $6,000
they borrowed to pay the coyotes fee. They have repaid only about
$1,300, Ms. Alvarado said. And they need $350 a month just for their
share of rent and utilities.
Ms. Alvarado must also send money to Honduras for her two daughters,
ages 7 and 9, who live with her mother. Tony has three daughters in
Honduras, too, living with their mother.
Because Jackson Antonio is a United States citizen entitled to
Medicaid, Ms. Alvarado gets a monthly ration of nine cans of baby
formula, as well as powdered milk, canned juice, and eggs and cheese
for her. But the staff at the food stamp office told her they were
required to report any applicant who was an illegal immigrant to the
authorities, so Ms. Alvarado did not apply.
She said she might return to Honduras because there was no point to
staying if she could not work. I came to make a future for my mother
and my girls, she said.
But if she can work, she will probably stay. And the baby boom may
even provide an opportunity. She said she might go into business
taking care of the babies of other Latino mothers.